Review: PocketDerm – An Online Dermatology & Prescription Acne Medication Service
Affiliate Links I Bought This August 25, 2014 | Reviews, Skincare, Treatment
I proclaim my love of the modern world pretty frequently in my every day life. I say it every time I walk into an air conditioned building, when I binge watch a new show on Netflix, and I say it when I’m able to read breaking news from the other side of the world on my smartphone when I’m in a car in the middle of the desert. When I first heard about PocketDerm, an online dermatology service that provides prescription acne medication for a monthly fee, I, without any hint of irony, actually uttered the words, “What a time to be alive!”
At the time, I still had a couple of months left on my Tretinoin prescription from my local dermatologist, but as soon as I picked up my last tube, I decided it was time to learn what PocketDerm was all about.
What is it?
PocketDerm is a teledermatology practice that offers online prescription acne treatments from an actual dermatologist from any smartphone or computer. The acne treatment prescribed is a custom compound medication that includes up to 3 actives, which can be any combination of niacinamide, clindamycin, tretinoin, or azealic acid, depending on what your PocketDerm doctor recommends. The actives are mixed into the company’s custom base, which includes ingredients that have been designed and tested to be pharmacologically stable with the active ingredients used in the prescriptions.
My personal PocketDerm prescription ingredients are:
Tretinoin (0.018%), Clindamycin (1%), Azealic Acid (8%)
Water, Vegetable Glycerin, Stearic Acid, Myristyl Myristate, Cetearyl Alcohol, Ceteareth-20, Glyceryl Stearate, Jojoba Seed Oil, Soybean Oil, Cetyl Alcohol, Carbomer, Shea Butter, Calendula Flower Oil, Passion Fruit Seed Oil, Rice Bran Oil, Acai Palm Fruit Oil, Phenoxyethanol, Ethylhexylglycerin.
In addition to the actives in a PocketDerm prescription, the base formula offers a host of plant oils that are rich in antioxidants and possess moisturizing and anti-inflammatory properties. Here’s a quick breakdown of the actives in my prescription:
Tretinoin, also known as all-trans retinoic acid, is a prescription strength form of Vitamin A that is frequently used to treat acne. It’s most commonly known under the popular brand name Retin-A, but is used in a number of other prescription formulas by other names as well. Tretinoin works by stimulating collagen production and regulating cell turnover. For more on Tretinoin, you can check out my review of Tretinoin Gel Microsphere 0.04%, which is what I was using before I made the switch to PocketDerm.
(Abstract) 40 years of topical tretinoin use in review
Journal of Drugs in Dermatology, June 2013
Clindamycin is an antibiotic that effectively treats acne by preventing the bacteria that causes acne from multiplying. It can be prescribed in the form of an oral or topical medication.
(Abstract) Efficacy and safety of clindamycin-tretinoin gel versus clindamycin or tretinoin alone in acne vulgaris: a randomized, double-blind, vehicle-controlled study
Journal of Drugs in Dermatology, March 2012
Azealic acid is a prescription medication that possesses antibacterial and anti-inflammatory properties. It also inhibits melanin synthesis, which makes it an effective treatment for conditions such as hyperpigmentation. It is frequently used to treat rosacea as well.
(Abstract) Azelaic acid in the treatment of acne in adult females: case reports
Skin Pharmacology & Physiology, November 2013
According to CosDNA, the major red flags (3 or higher out of 5) in the base formula for PocketDerm include myristyl myristate, which gets a 5 out of 5 as a potential acne trigger, and soybean oil, which gets a 3 out of 5 as a potential acne trigger.
How the Service Works
The PocketDerm service charges a flat fee of $20 a month. This fee covers all of your consultations (you can have as many as you need), and all of your medication. The PocketDerm medication ships every 90 days by default, but you can increase the delivery frequency for no extra charge if you find you’re going through your medication faster.
When I signed up, I was taken through a short series of questions about my acne history, severity, and frequency. I was then asked to upload three, well-lit photos of my face (two side views and one frontal view). After that, I received a message letting me know that Dr. Lortscher (AKA Dr.L) would contact me within the next couple of days.
I actually ended up getting a response just a few hours later, even though it was a weekend. I was extremely impressed with the speed of the service. I imagine the response time varies widely depending on workload and other obligations, but so far, every time I’ve sent a message through the websites messaging service, the response has been very quick. The communication was also extremely friendly – for some reason I’d expected it to be cold, so I was pleasantly surprised by the approachable tone of the conversation. Dr L made recommendations, asked questions, and even complimented my “epic” cleanser collection.
Five days later, my PocketDerm prescription arrived in the mail.
The packaging for PocketDerm medication is significantly more attractive than any tube of tretinoin I’ve ever had. It comes packaged in an airless pump, with the PocketDerm logo on the front and directions for use on the back.
The product itself is an opaque, white lotion. It’s not watery at all, but it is very easy to spread.
The PocketDerm cream has a nice, low, pH of 4.5.
There is no added fragrance in the PocketDerm medicine. If I try very hard, I can smell the generic scent of any sort of cream based skincare product.
I apply 3 pumps of PocketDerm medication to my face in the evening, after I’ve applied all of my low pH products and waited 20 minutes (It’s the 6th step in my evening skincare routine). I apply by dabbing the cream on my forehead, nose, cheeks, and chin, and then rubbing it in. The product absorbs quickly and easily, and is not greasy, sticky, or shiny once absorbed. I then finish the remainder of my routine.
I’ve been using PocketDerm nightly for about 10 weeks. I find the formula to be extremely gentle, and have not experienced any irritation or breakouts as a result of using this medication. It has done an excellent job keeping my acne away, which is fantastic. But there is also another added benefit – I had two, fresh, fairly severe PIH marks when I started using my PocketDerm prescription, and noticed the speed at which those spots lightened accelerated dramatically once I started using PocketDerm. I suspect the azealic acid component deserves the credit for this – nonetheless, I am overjoyed.
In the past, I’ve received messages from readers who were unable to get to a dermatologist either because it was cost prohibitive or because of a lack of transportation, and I always felt terrible that I had nowhere safe and reliable to send them. After using the service myself, I think PocketDerm offers an amazing alternative for those who have previously been unable to get to a dermatologist. The cost is extremely reasonable, especially when you consider that the $20 a month fee covers your ongoing medical consultation as well as 3 acne medications combined into a single product.
The PocketDerm website has an FAQ, in which they say if you already have a dermatologist, it’s best to continue getting the face-to-face care the in-person doctor can provide. I think this is sound advice – however, I have personally found that the convenience of being able to do everything online combined with the reduced hassle from getting 3 prescription actives in a single product is far more convenient and cost effective for me. I’ll still go see my dermatologist for my yearly mole check, but my acne is in the hands of PocketDerm now.
There are some limitations to the service. PocketDerm requires parental consent for anyone under 18 years of age, and can not treat any patients under the age of 13. I know Dr.L is working to make this service available in as many areas as possible, but currently, this service is only available in the following states:
Alabama, Alaska, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Vermont, Washington, Washington, D. C., Wisconsin, and Wyoming.
Pros & Cons
Skin & Tonics Rating
|B+||20/20 Efficacy||9/20 Ingredients||20/20 Application||20/20 Wear||20/20 Packaging|
|Total: 89||Rating system details »|
Where to Buy
|PocketDerm Online Dermatology & Prescription Acne Medication||$19.95/month (First month is free!)||The first month is FREE when you sign up though S&T.||buy|
This post contains affiliate links. Shopping these links helps support this site. Full disclosure »
I’ve been using the same exact formulation for about two months now and I’m slowly seeing results. Correct me if I’m wrong, but you were using a stronger % of tretinoin before, right? Have you seen any negative effects from “downgrading” as it were?
Yes, my previous Tretinoin prescription contained a higher percentage of Tretinoin – 0.04%. Dr.L said the .018% in this formula should be comparable – I presume it’s because my old prescription was the time release version and this one is not. So far I haven’t seen any decrease in efficacy from the lower percentage.
Did you also have PIH marks when you started yours?
Yes, a little bit. I have this one area on my face that erupts into painful breakouts frequently (why there?!) and both the breakouts and redness have lessened since I started PocketDerm. I wasn’t using tretinoin before though so I think there was a longer adjustment period.
Oh yeah. I used to have an area that always erupted. It was always the right jawline for me, close to my chin area. It’s been clear for a long time, but it would erupt so badly for so long, I can still remember exactly how those breakouts felt.
I didn’t have any sort of peeling or adjustment period for PocketDerm since I was already using Tretinoin before. Since this was your first time using it, did you experience any side effects? Any dryness, peeling, or sensitivity? I am curious about how the difference in the Pocketderm base formula would have affected my Tretinoin adjustment if that had been my initial experience with it.
I haven’t had much in the way of peeling or excessive dryness, which surprised me. What did happen was a bit of an acne “purge” … an eruption of small, non-painful zits, mostly on my forehead. I’m assuming this was a result of PocketDerm because I made a point of not starting any other new skincare around that time. The face eruption ended after about two weeks though so no biggie? I would say my skin feels slightly more sensitive, although that’s diminishing the longer I use it. When I first started I couldn’t really use other exfoliants (mainly BHA, in the morning) without leaving my skin feeling overly tender. I didn’t want to push it too much, I guess? But now I’m back to using my normal stuff during the daytime without issues.
I’ve noticed my PIH getting significantly lighter WAY faster since I started Pocketderm too! I had a wicked cystic pimple right before I started it and they usually leave a giant reddish/brownish face scar for mooooonths. I swear, like 4-6 months. I dread the cysts not for the zits themselves but for the PIH.
Anyway, it lightened a ton in the first few weeks and is almost completely faded now after 2 months. I should have taken a before and after!
I wish I had $1 for every time I wished I’d taken a before and after for something. I’d be so disgustingly rich by now!
Thanks for the review! I just signed up yesterday night, and they already shipped my first prescription. My formulation has 4% niacinamide, 1% clindamycin, and 4% azelaic acid. I’ve never been prescribed niacinamide or azelaic acid before. I’m pretty excited to try it, and because I took those initial pictures, I do have some very clear before pictures. It felt kind of embarrassing to upload them…but hopefully I’ll have good results. 😀
This was my first time trying Azealic acid (in a meaningful amount) too, Diana. I am a huge fan now. You’ll have to let me know what you think of yours when you’ve had a chance to use it for a bit! I’m curious – do you have any issues with PIH?
Yeah, I do have a bit of PIH as well as quite a bit active acne right now. It seems like the pimples that I get on my cheeks tend to leave pretty dark marks. I think I had some contaminated Benton products. I had never experienced itchy acne before…
I live outside the US but this seems like such a good thing to have over there, where access to a doctor isn’t easy for everyone (I’ve been lucky that I’ve been going to a dermatologist once every 2 or 3 months for the past 4 years for free because of Spanish’s social healthcare). It is great that the service is good and not the usual internet “cold” treatment!
I don’t think I’ve used azealic acid in “high” proportions, so I might ask my dermatologist in the next visit if it would be beneficial for me.
Anyway, it was very good to read that companies like this exist!
I’d love to know how your azealic acid experience turns out, Idoia! 🙂
I’m really on the fence about this! I have a few months left of my prescriptions – Trentinoin and Clindamycin. Between these two prescriptions and the skincare routine I started (thanks, in a large part, to your awesome blog!) , and a total ban on touching my face during the day everything has cleared up except for the patches on my forehead where my running hat sits and sweat collects during long runs (any ideas for this?). As someone with really, really bad acne just a few months ago I keep thinking to myself, “Can it get any better than this?”
We moved and my insurance has changed, though. I’m not exactly sure what to do next! I’ll probably hold out with what I have now and when things run out I’ll see if I can get a comparable aesthetic dermatologist here. If not then I’ll go with Pocket Derm.
I totally get that, Elizabeth! I would have the same hang-ups in your position. If you do eventually decide to go the PocketDerm route, I would love to know how you think it compares to your current treatment! 🙂
I’m curious what you think of their stance on wait times. I was told by Dr. Lortscher that there was no need to wait after cleansing or before moisturizing, though this goes against what derms usually recommend when using tretinoin. My formula is 0.06% tret, 1% clindamycin, and 6% azelaic acid and I have used tretinoin off and on for the past 4 years and was always told to wait 10-20 minutes post-wash to apply, and 30-60 minutes for moisturizing.
Hey Sarah! I was also told to wait with my pervious Tretinoin prescription. I’ve ditched the wait time for PocketDerm per the instructions, and haven’t seen any decrease in efficacy or suffered any ill effects. I’m happy to have one less wait time in my routine! 🙂
this seems like a really great option for individuals without health insurance. I myself would probably not use this service since my retin a prescription is only $30 and will last me forever, but this would be something I would think about in the future if I want to try out some of those other actives.
I’m currently not seeing any sort of effects from using retin a. Granted I am starting slowly and only used it twice a week for a few weeks and will soon begin bumping it up to three. It doesnt seem to have lightened up any of my PIH marks yet or helped with any active breakouts I have had. I am scared to use it every night, so I am going slow. Hopefully this is the reason why I havent seen any marked changes.
Hi LH! I jumped right in with every other night usage when I started Tretinoin, I saw changes fairly quickly, but I also definitely experienced the peeling/drying/sensitivity side effects. However, it wasn’t as bad as I expected it to be. How often did your doctor prescribe you to use it?
my doctor said to just use it at night but I was going off of a recommendation of my sister who started tretinoin 0.01 about five or so months before I did. Her doctor told her to use it once a week for a few weeks then bump it up to two and so on. He told her to wash her face, then wait 45-60 min before applying it and wait another 30-45 before moisturizing. I have been following this routine and have never experienced any sort of redness or dryness or peeling. It almost made me feel like it wasnt working since I never saw those effects. Maybe I will start seeing greater results once I up my usage
Keep me posted, LH – I’m curious to how Tretinoin works out for you in the long run! 🙂
Oh wow, this sounds very interesting. Thanks for the post, I’ll look into this when I’m closer to empty on my current retinol product.
Is the base static for all formulations, though? Shea butter is a big no-no for me, clogs my pores like crazy.
Hi Mairi! The base is static for all formulations. Both of the PocketDerm doctors did an AMA on Reddit a few weeks ago, and mentioned the possibility of a gel base option in the future. I don’t know how far in the future it would be – it sounds like they do some pretty extensive testing before putting anything on the market.Here’s the AMA, in case you’re interested in reading more about it:
i heard they’ve updated their formulas now!
Though the ingredient list would led one to believe this being a heavy and rich cream, that’s not the case at all. I was actually surprised and relieved at how light it is, as it absorbed into my combo/oily skin in about 30 sec, and I was 3 pumps. In about a minute it sets to a matte finish, and I can no longer feel it on my skin.
I would suggest you give it a try, the shea butter is pretty low on the ingredient list, and with Kerry’s link, the first month is free.
Wow that’s amazing. I thought this was going to be another service where you have to supply the prescription, etc. I had no idea medication was allowed to be prescribed in this way. I’m highly interested in this service for myself now. Thanks for sharing 🙂
Apparently telemedicine laws have been changing to allow easier access to specific types of medical services, which is why something like PocketDerm has only just become available recently. I’m excited to see what other visually-diagnosable conditions become more accessible in the near future. This is such an interesting time for medicine in the US!
I’ve heard good things about PocketDerm but this is the first thorough review I’ve seen. Thank you!
This seems like such a great service! I really really wish it were available internationally, but maybe in the future, who knows. I have made very bad experiences with any derm so far so I would really love to try this. Most derms don’t even look and me, say Ive got light acne and send me on the way with some product. I really hate this and I don’t know if that’s a problem in general or if I am just very unlucky. Thanks for sharing this and I dearly hope I will be able to order some day 🙂 Great it worked so well for you!
Argh! Another reason to move out of Texas. 🙁 Great post!
Too bad it’s not available in Texas! Have you looked into the Skin Salvation line from the acne clinic in SF? I tried a basic cleanser and a tinted SPF and liked them both, but the SPF is wicked hard to wash off.. They have toners as well, curious on your take! http://www.skinsalvationsf.com
I haven’t tried that line before, Amy! The ingredient lists looks promising though! 🙂
I’m currently using 0.025% Tretinoin from my PCP — and it’s been working great for my cystic acne. However, even at that low a concentration, I can only use it every 2-3 days. Any more frequently and I would end up with dry, flaky, sensitive skin. Hence, a 45ml tube can last me at least a year, so it wouldn’t be cost-effective for me to use Pocketderm.
However, I love that it’s an available option! I might be allergic to clindamycin, but a combination of niacinamide/azelaic acid, and tretinoin in 1 product sounds amazing. If my insurance ever stops paying for tretinoin in the future, I’ll definitely be checking this out. 🙂
It’s such a great option, Emy! Though I probably wouldn’t switch in your position either – one tube a year is very easy on the wallet! 🙂
I was very thankful to hear about this service and that it was available in my state. The Dr is nice. It is embarrassing and hard to upload photos, but so much more convenient and budget friendly. I think my inflamed rosacea sensitive skin can’t tolerate tretinoin unfortunately, but I’m glad to have tried it. Luckily, after a month of checking it out being sure it was too harsh even with attempted minimal and careful use, there was no problem changing my formulation to the niacinimide (tretinoin-free) one mentioned on this page in the comments. I’m told my new formulation will be shipped out soon. Glad it’s looking like I won’t have to wait til the next scheduled delivery to switch and hopefully get some improvement and relief!
I’m wondering what you’d recommend to someone recovering from sensitivity and possible impaired barrier function from using tretinoin? Like if you were starting out again going through that adjustment period, what would you do with the rest of your skincare routine based on what you’ve learned from your own experiences to improve tolerance, as well as recovery?
I’ve been wanting to try this. Are you still using this? I would love an update! I also would love to hear about your routine with this also!